2015-11-13T11:06:59-06:00 2014-12-31 PricewaterhouseCoopers LLP 300 Madison Avenue New York NY 10017 990 2014-01-01 113403968 CATHOLIC HEALTH SYSTEM OF LONG ISLAND % CATHOLIC HEALTH SERVICES OF CATH 5167053700 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 ALAN D GUERCI MD PRESIDENT & CEO 6464713000 2015-11-11 true LAURA PARELLO P01080295 6464713000 2014 2016-04-25 22:37:26Z CATHOLIC HEALTH SERVICES OF LI ALAN D GUERCI MD 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 52168587 false 0928 X HTTP://WWW.CHSLI.ORG X 1997 NY CHSLI AND ITS MEMBERS, AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUE CHRIST'S HEALING MISSION, BY PROMOTING EXCELLENCE IN CARE AND COMMITTING ITSELF TO THOSE IN NEED. 23 22 13 0 0 12814178 28002577 21387807 23490016 966081 675994 0 0 35168066 52168587 9359454 36244526 0 0 10056037 10099894 0 0 0 12010201 14541046 31425692 60885466 3742374 -8716879 151297149 234011841 147143754 238621850 4153395 -4610009 X CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHSLI), AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION, PROMOTES EXCELLENCE IN CARE, AND COMMITS ITSELF TO THOSE IN NEED. CHS AFFIRMS THE SANCTITY OF LIFE, AND ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. IT CONDUCTS ITS HEALTHCARE PRACTICE, BUSINESS, EDUCATION AND INNOVATION WITH JUSTICE, INTEGRITY AND RESPECT FOR THE DIGNITY OF EACH PERSON. false false 20513233 69966 23490016 CATHOLIC HEALTH SERVICES OF LONG ISLAND PROMOTES THE EFFICIENT GOVERNANCE AND MANAGEMENT OF THE SUPPORTED ORGANIZATIONS. IN ADDITION, CHSLI'S COOPERATIVE PLANNING AND EFFICIENT USE OF RESOURCES ASSISTS THE SUPPORTED ORGANIZATIONS TO ACHIEVE THEIR RESPECTIVE AND COLLABORATIVE GOALS. 1250000 1250000 0 SUPPORTING AND STRENGTHENING THE MINISTRIES OF THE DIOCESE OF ROCKVILLE CENTRE. 34634526 34634526 0 SUPPORTING AND STRENGTHENING THE MINISTRIES OF THE CHSLI HEALTH SYSTEM AND RELATED ORGANIZATIONS. 290034 290034 0 56687793 true true false false false false false false false false true false true true true true false true false false false false false false false false false true false true true false false false false false false false false false false false false false false true true true true false false true 53 0 true 13 true false false false false false false false false false false X 23 22 false false false false true true true true true false false true true true true true true true true true false X CATHOLIC HEALTH SERVICES OF 5167051938 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 X SISTER ELAINE CALLAHAN OP VICE CHAIR THRU APRIL 2014 2.0 0.0 X X 0 0 0 THOMAS E CHRISTMAN TREASURER THRU APRIL 2014 2.0 0.0 X X 0 0 0 EUGENE MURPHY SECRETARY THRU APRIL 2014 2.0 0.0 X X 0 0 0 SISTER MARGARET JOHN KELLY DC TRUSTEE THRU APRIL 2014 2.0 0.0 X 0 0 0 RICHARD JJ SULLIVAN JR CHAIR 2.0 0.0 X X 0 0 0 BARBARA ELLEN BLACK TRUSTEE 2.0 0.0 X 0 0 0 THOMAS DOWLING JR MD TRUSTEE 2.0 0.0 X 0 0 0 VIRGINIA EWEN TRUSTEE 2.0 0.0 X 0 0 0 SISTER AUDREY HARSEN TRUSTEE 2.0 0.0 X 0 0 0 FRANK L KURRE TRUSTEE 2.0 0.0 X 0 0 0 BRIAN MCGUIRE VICE CHAIR 2.0 0.0 X X 0 0 0 REV MSGR ROBERT MORRISSEY TRUSTEE 2.0 0.0 X 0 0 0 PATRICIA NAZEMETZ TRUSTEE 2.0 0.0 X 0 0 0 CHRIS PASCUCCI TREASURER 2.0 0.0 X X 0 0 0 DANIEL T ROWE TRUSTEE 2.0 0.0 X 0 0 0 JOSEPH TANTILLO SECRETARY 2.0 0.0 X X 0 0 0 JOHN WAGNER TRUSTEE 2.0 0.0 X 0 0 0 REV JAMES VLAUN TRUSTEE 2.0 0.0 X 0 0 0 KEVIN J CONWAY TRUSTEE AS OF APRIL 2014 2.0 0.0 X 0 0 0 PETER D'ANGELO TRUSTEE AS OF APRIL 2014 2.0 0.0 X 0 0 0 REV PETER DUGANDZIC TRUSTEE AS OF APRIL 2014 2.0 0.0 X 0 0 0 BRIAN P HEHIR TRUSTEE AS OF APRIL 2014 2.0 0.0 X 0 0 0 HON ANTHONY MARANO TRUSTEE AS OF APRIL 2014 2.0 0.0 X 0 0 0 STEPHEN F MCLOUGHLIN TRUSTEE AS OF APRIL 2014 2.0 0.0 X 0 0 0 JEROME POLLER TRUSTEE AS OF APRIL 2014 2.0 0.0 X 0 0 0 SALVATORE SODANO TRUSTEE AS OF APRIL 2014 2.0 0.0 X 0 0 0 ALAN D GUERCI MD PRESIDENT & CEO 50.0 0.0 X X 1230209 0 247778 COLLEEN BLYE EXECUTIVE VP & CFO 50.0 0.0 X 797602 0 303419 DENNIS VERZI EXECUTIVE VP & COO 50.0 0.0 X 1093189 0 101656 DAVID DECERBO EVP & GENERAL COUNSEL 50.0 0.0 X 615763 0 125910 ANTHONY PELLICANO SVP CHIEF HR OFFICER 50.0 0.0 X 522660 0 118894 PATRICK O'SHAUGHNESSY SVP MEDICAL AFFAIRS & CMO 50.0 0.0 X 699045 0 318134 JOSEPH TOMAINO EVP CONTINUING CARE THRU JAN14 50.0 0.0 X 1078251 0 497133 RICHARD MULRY SVP PHYSICIAN NETWORK 50.0 0.0 X 408815 0 28954 LAWRENCE MCMANUS FORMER PRESIDENT & CEO 0.0 0.0 X 740573 0 13627 JAMES CALDAS FORMER EVP STRATEGIC PLANNING 0.0 0.0 X 1939643 0 198703 9125750 0 1954208 12 true true false ISEMAN CUNNINGHAM RIESTER HYDE 9 THURLOW TERRACE ALBANY NY 12203 LEGAL SERVICES 1459280 KPMG LLP 345 park avenue NEW YORK NY 10154 AUDITING SERVICES 1119800 PROSKAUER ROSE LLP 1585 BROADWAY NEW YORK NY 10036 LEGAL SERVICES 494830 TERENCE M OBRIEN 199 JOHNSON ROAD SCARSDALE NY 10583 CONSULTING SERVICES 419125 DELLA FEMINA ROTHSCHILD JEARY 129 WEST 29TH STREET NEW YORK NY 10001 ADVERTISING 250000 12 27843562 159015 28002577 MANAGEMENT SERVICES REVENUE 900099 23490016 23490016 23490016 675994 675994 0 0 0 0 0 0 0 0 0 0 52168587 23490016 675994 36244526 36244526 0 0 0 3773853 3773853 0 4712571 4712571 1058712 1058712 193799 193799 360959 360959 1275803 1275803 2894334 2894334 1159783 1159783 0 0 0 33907 33907 0 271106 271106 0 0 132988 132988 41065 41065 0 0 0 4701721 4701721 47762 47762 10568 10568 OTHER EXPENSES 3972009 3972009 0 0 60885466 56687793 4197673 0 55073123 27147729 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1914980 2781291 2582275 2467358 127028 114917 0 34999821 0 0 20526936 86834885 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false false false false false false false true false PART IV, SECTION A, LINE 1 THE SUPPORTED ORGANIZATIONS OF CATHOLIC HEALTH SYSTEM OF LONG ISLAND RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 109793 103140 6653 146704 144591 2113 2321314 2217368 103946 4464 2259 2205 114917 TRUSTEE HELD ASSETS 86834885 F 86834885 DUE FROM RELATED ORGANIZATIONS 48725565 INVESTMENT IN SUBSIDIARIES 2250000 EXECUTIVE RETIREMENT ASSETS 17233997 AWUL FREECARE 4870672 DONOR RESTRICTED FUNDS 362802 457B FUNDS 734803 EQUITY INVESTMENTS 7955359 82133198 0 DUE TO RELATED ORGS & AFFILIATES 850000 EXECUTIVE RETIREMENT LIABILITY 17871395 18721395 X PART X, OTHER LIABILITIES - LINE 2, FIN 48 FOOTNOTE CHS AND MOST OF ITS SUBSIDIARIES ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. CHS ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE CODIFICATION TOPIC 740, INCOME TAXES. MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS, USING A THRESHOLD OF MORE LIKELY THAN NOT OF BEING SUSTAINED. true DIOCESE OF ROCKVILLE CTR-CATHOLIC MINISTRIES 50 N PARK AVEROCKVILLE CNTRNY 11 ROCKVILLE CTR NY 11570 111837437 501(c)(3) 1250000 NONE NONE GENERAL SUPPORT WSNCHS INC (ST JOSEPH) 4295 HEMPSTEAD TURNPIKEBETHPAGE N BETHPAGE NY 11714 113438973 501(C)(3) 13680000 NONE NONE GENERAL SUPPORT ST CHARLES HOSPITAL 200 BELLE TERRE RD PORT JEFFERSON MANCHESTER CT 06042 111871039 501(C)(3) 7554526 NONE NONE MEDICAL CARE HAITI ST CATHERINE OF SIENA MEDICAL CENTER 50 ROUTE 25ASMITHTOWN NY 11787 ROSEDALE NY 11422 061562701 501(C)(3) 13400000 NONE NONE GENERAL SUPPORT AMERICAN RED CROSS PO BOX 33093 NEWARK NJ 07188 AMITYVILLE NY 11701 530196605 501(C)(3) 10179 NONE NONE FIRST AID SUPPLIES CATHOLIC CHARITIES DIOCESE OF ST PETESBURG 3228 SAN JOSE MISSION DR DOVER FL DOVER FL 33527 590875805 501(C)(3) 17000 NONE NONE PRIMARY CARE SERVICES CHRISTIAN HELP IN MINGO COUNTY PO BOX 1257 KERMIT WV 25674 KERMIT WV 25674 550750315 501(C)(3) 15000 NONE NONE GENERAL SUPPORT CONGREGATION OF HOLY CROSS US PROVINCE 500 WASHINGTON ST NORTH EASTON MA NORTH EASTON MA 02356 320344245 501(C)(3) 10000 NONE NONE CONSTRUCTION OF CLINIC DANIEL C NWANKWO MD MEMORIAL FOUNDATION 3 QUINCY CIRCLE SOUTH BARRINGTON SOUTH BARRINGTON IL 60010 066494955 501(C)(3) 30000 NONE NONE MEDICAL EQUIPMENT LJDR DAVIS FOUNDATION 134-36 246 ST ROSEDALE NY 11422 ROSEDALE NY 11422 462216693 501(C)(3) 10000 NONE NONE PROMOTE WELLNESS RELIGIOUS OF SACRED HEART MARY 50 WILSON PARK DR TARRYTOWN NY 10 TARRYTOWN NY 10591 136093471 501(C)(3) 68650 NONE NONE MEDICAL EQUIPMENT ROTACARE 20 COLONY LA SYOSSET NY 11791 SYOSSET NY 11791 113135331 501(C)(3) 35000 NONE NONE MEDICATION & EQUIPM TUTWILER CLINIC 205 ALMA ST TUTWITER MS 38963 TUTWITER MS 38963 640678336 501(C)(3) 16008 NONE NONE MEDICAL EQUIPMENT UPLIFT HELP INTERNATIONAL INC 984 N VILLAGE AVE ROCKVILLE CNTR ROCKVILLE CENTER NY 11571 203821339 501(C)(3) 20000 NONE NONE MEDICAL FACILITY URSULINE SISTERS OF TILDONK 60 ANCHOR AVE OCEANSIDE NY 11572 OCEANSIDE NY 11572 112305323 501(C)(3) 38297 NONE NONE PURCHASE AMBULANCES 15 PART I, LINE 2 - PROCEDURE FOR MONITORING GRANT FUND USE THE DIOCESE OF ROCKVILLE CENTRE PROVIDES ANNUAL UPDATES TO ALL CONTRIBUTORS TO THE CATHOLIC MINISTRIES APPEAL; WHETHER PARISHIONERS OR CORPORATE CONTRIBUTORS LIKE CHSLI. CHS SERVICES, A RELATED ENTITY, MAINTAINS THE BOOKS AND RECORDS FOR CATHOLIC HEALTH SYSTEM OF LONG ISLAND AND WSNCHS, INC. (ST JOSEPH HOSPITAL), ST. CATHERINE OF SIENA MEDICAL CENTER, AND ST. CHARLES HOSPITAL AND IS THEREFORE ABLE TO MONITOR THAT THE GRANT FUNDS ARE USED AS GENERAL SUPPORT. THE CATHOLIC HEALTH SERVICES OF LONG ISLAND CAREGIVERS FUND WAS FORMED WITH THE MISSION TO ASSIST OUR FELLOW CAREGIVERS ON THE FRONT LINES, HERE AND ABROAD, WHO STRUGGLE JUST TO OBTAIN BASIC RESOURCES TO PROVIDE CARE TO THOSE DESPERATELY IN NEED. THE CAREGIVERS COMMITTEE, COMPRISED OF STAFF WHO ARE DONATING THEIR SERVICES, MANAGE THE CAREGIVERS FUND. THROUGHOUT THE YEAR, ORGANIZATIONS SUBMIT GRANT APPLICATIONS TO REQUEST FUNDS THAT ARE USED TO OBTAIN BASIC RESOURCES TO PROVIDE CARE TO THOSE DESPERATELY IN NEED. THE CAREGIVERS COMMITTEE REVIEWS THESE APPLICATIONS, AND CHOOSES RECIPIENTS BASED ON THE FOLLOWING CRITERIA: I) CLEAR AND IDENTIFIED NEED, II) ABILITY TO USE THE FUNDS RESPONSIBLY, III) CARE FOR THE CAREGIVERS ON THE FRONT LINE, IV) ABILITY OF THE RECIPIENTS TO USE THE FUNDS FOR THE RECOMMENDED PURPOSES, AND V) CONFIRMATION OF THE LEGAL STATUS OF THE RECIPIENT. FOLLOWING SELECTION, THE COMMITTEE DIRECTS THE GIFTS TO BE MADE TO RECIPIENTS WITH COVER LETTERS INDICATING THE INTENDED PURPOSES. RECIPIENTS ARE ASKED TO PROVIDE FOLLOW-UPS ON THE USE OF THE FUNDS TO THE COMMITTEE WITHIN SIX MONTHS OF THE USE OF FUNDS. PART II, LINE 1 COLUMN (H) NAME OF ORGANIZATION OR GOVERNMENT: DIOCESE OF ROCKVILLE CENTRE - CATHOLIC MINISTRIES APPEAL (H) PURPOSE OF GRANT OR ASSISTANCE: TO PROVIDE GENERAL SUPPORT OF THE CATHOLIC MINISTRIES OF THE DIOCESE OF ROCKVILLE CENTRE IN CONNECTION WITH THE FORMATION OF YOUTH AND ADULTS IN THE FAITH, PROMOTION OF THE DIGNITY OF LIFE, PROMOTION OF QUALITY EDUCATION FOR YOUNG PEOPLE, AND FOSTERING OF VOCATIONS FOR THE PRIESTHOOD. X true true X X X X X X true true false false false false false false false ALAN D GUERCI MD PRESIDENT & CEO 1199882 0 0 0 30327 0 216396 0 31382 0 1477987 0 0 0 COLLEEN BLYE EXECUTIVE VP & CFO 768651 0 0 0 28951 0 274396 0 29023 0 1101021 0 0 0 DAVID DECERBO EVP & GENERAL COUNSEL 589836 0 0 0 25927 0 95396 0 30514 0 741673 0 0 0 DENNIS VERZI EXECUTIVE VP & COO 839064 0 0 0 254125 0 89396 0 12260 0 1194845 0 120899 0 ANTHONY PELLICANO SVP CHIEF HR OFFICER 499878 0 0 0 22782 0 117396 0 1498 0 641554 0 0 0 PATRICK O'SHAUGHNESSY SVP MEDICAL AFFAIRS & CMO 681525 0 0 0 17520 0 290396 0 27738 0 1017179 0 0 0 JOSEPH TOMAINO EVP CONTINUING CARE THRU JAN14 25040 0 0 0 1053211 0 478239 0 18894 0 1575384 0 296092 0 LAWRENCE MCMANUS FORMER PRESIDENT & CEO 0 0 0 0 740573 0 0 0 13627 0 754200 0 742817 0 JAMES CALDAS FORMER EVP STRATEGIC PLANNING 0 0 0 0 1939643 0 188000 0 10703 0 2138346 0 1738371 0 RICHARD MULRY SVP PHYSICIAN NETWORK 390415 0 0 0 18400 0 19396 0 9558 0 437769 0 0 0 PART I, LINE 4A - SEVERANCE PAYMENT LAWRENCE MCMANUS, FORMER PRESIDENT & CEO RECEIVED PAYMENT OF SEVERANCE OF $580,065. MEDICAL BENEFITS WERE ALSO PROVIDED DURING 2014. JAMES CALDAS, FORMER EVP STRATEGIC PLANNING RECEIVED PAYMENT OF SEVERANCE OF $880,019. MEDICAL BENEFITS WERE ALSO PROVIDED DURING 2014. JOSEPH TOMAINO, EVP CONTINUING CARE RECEIVED PAYMENT OF SEVERANCE OF $654,172 AND IS ENTITLED TO ADDITIONAL SEVERANCE OF $341,239. PART I, LINE 4B - SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS BELOW ARE INCLUDED ON SCHEDULE J, PART II, COLUMN C. JAMES CALDAS $188,00 PARTICIPATION IN PLAN ALAN D. GUERCI, MD $197,000 PARTICIPATION IN PLAN COLLEEN BLYE $255,000 PARTICIPATION IN PLAN JOSEPH TOMAINO $137,000 PARTICIPATION IN PLAN DAVID DECERBO $76,000 PARTICIPATION IN PLAN ANTHONY PELLICANO $98,000 PARTICIPATION IN PLAN DENNIS VERZI $70,000 PARTICIPATION IN PLAN PATRICK O'SHAUGHNESSY $271,000 PARTICIPATION IN PLAN THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THESE INDIVIDUALS INCLUDES BOTH QUALIFIED AND NON-QUALIFIED RETIREMENT PLANS. THE FOLLOWING INDIVIDUALS VESTED IN THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS BELOW ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B(III). THESE AMOUNTS INCLUDE A TAX GROSS UP. LAWRENCE MCMANUS $160,508 VESTED IN PLAN JAMES CALDAS $984,725 VESTED IN PLAN JOSEPH TOMAINO $398,798 VESTED IN PLAN DENNIS VERZI $230,389 VESTED IN PLAN THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2014 FORM W-2, BOX 5 AS TAXABLE WAGES BECAUSE THEY ARE VESTED, BUT ARE NOT DISTRIBUTED UNTIL RETIREMENT. A SUFFOLK COUNTY ECONOMIC DEVELOPMENT CORP 273722095 86476RAU8 2011-12-14 192616434 CAPITAL EXPEN, REFUNDING 1999,2000 false false false B NASSAU COUNTY LOCAL ECONOMIC ASSISTANCE CORP 274291221 63165BAKO 2011-12-14 65530479 CAPITAL EXPEN, REFUNDING 1999,2000 false false false A 0 0 192616434 0 0 0 3077681 0 0 11128918 178409835 0 false false true true B 0 0 65530479 0 0 0 1093112 0 0 26766090 37671277 0 false false true true A false true true true false 0 false false false true B false true true true false 0 false false false true A false true false false false false 0 false 0 false true B false true false false false false 0 false 0 false true A true B true SCHEDULE K THE TAX-EXEMPT BOND ISSUANCES REFLECTED IN SCHEDULE K, PART I ARE ISSUED ON BEHALF OF CATHOLIC HEALTH SYSTEM OF LONG ISLAND'S RELATED OPERATING ENTITIES. PLEASE NOTE THAT SCHEDULE K, PARTS II, III AND IV HAVE BEEN COMPLETED BASED ON THE TOTAL AMOUNT OF THE TAX-EXEMPT BOND ISSUANCES FOR THE GROUP, NOT BY EACH INDIVIDUAL ENTITY, AS THE OFFERING WAS ON BEHALF OF THE GROUP AS A WHOLE. SCHEDULE K, PART III ALL THE BONDS LISTED ON SCHEDULE K REPORT PRIVATE BUSINESS USE OF 0% FOR TAX YEAR ENDED 12/31/2014. CATHOLIC HEALTH SYSTEM OF LONG ISLAND'S BOND COUNSEL HAS A PROCESS IN PLACE TO MONITOR PRIVATE BUSINESS USE. FOR CERTAIN PROJECTS, IN ADDITION TO USING BOND PROCEEDS, CATHOLIC HEALTH SERVICES OF LONG ISLAND HAS USED EQUITY AND SUCH EQUITY HAS BEEN ALLOCATED TO POTENTIAL PRIVATE BUSINESS USE OF SUCH PROJECTS. SCHEDULE K, PART I, LINE C SUPPLEMENTAL INFORMATION SECOND ISSUER FOR LINE C IS: NASSAU COUNTY LOCAL ECONOMIC ASSISTANCE CORP, EIN #27-4291221, CUSIP# 63166LDJ7 SCHEDULE K, PART I, LINE D SUPPLEMENTAL INFORMATION THIS BOND FULLY REFUNDED THE 2004 BONDS, WHICH WERE REPORTED ON THE ST. FRANCIS HOSPITAL FORM 990, SCHEDULE K. ALTHOUGH ON DECEMBER 17, 2013, THE CORPORATE MEMBERS OF CATHOLIC HEALTH SERVICES OF LONG ISLAND ADOPTED A RESOLUTION RESTRUCTURING THE GOVERNANCE OF CHS SO THAT A SINGLE MIRROR BOARD GOVERNS CHS AND THE SIX ACUTE CARE OPERATING ENTITIES, THE REFERENCED CHANGE WAS EFFECTUATED BY ENACTMENT OF A RESOLUTION AND DID NOT ENTAIL A CHANGE TO THE ORGANIZING DOCUMENT OR BYLAWS. FORM 990, PART III, LINE 4D - OTHER PROGRAM SERVICES THE CATHOLIC HEALTH SERVICES OF LONG ISLAND CAREGIVERS FUND WAS FORMED WITH THE MISSION TO ASSIST OUR FELLOW CAREGIVERS ON THE FRONT LINES, HERE AND ABROAD, WHO STRUGGLE JUST TO OBTAIN BASIC RESOURCES TO PROVIDE CARE TO THOSE DESPERATELY IN NEED. THE CAREGIVERS COMMITTEE, COMPRISED OF STAFF WHO ARE DONATING THEIR SERVICES, MANAGE THE CAREGIVERS FUND. THROUGHOUT THE YEAR, ORGANIZATIONS SUBMIT GRANT APPLICATIONS TO REQUEST FUNDS THAT ARE USED TO OBTAIN BASIC RESOURCES TO PROVIDE CARE TO THOSE DESPERATELY IN NEED. THE CAREGIVERS COMMITTEE REVIEWS THESE APPLICATIONS, AND CHOOSES RECIPIENTS BASED ON THE FOLLOWING CRITERIA: I) CLEAR AND IDENTIFIED NEED, II) ABILITY TO USE THE FUNDS RESPONSIBLY, III) CARE FOR THE CAREGIVERS ON THE FRONT LINE, IV) ABILITY OF THE RECIPIENTS TO USE THE FUNDS FOR THE RECOMMENDED PURPOSES, AND V) CONFIRMATION OF THE LEGAL STATUS OF THE RECIPIENT. FOLLOWING SELECTION, THE COMMITTEE DIRECTS THE GIFTS TO BE MADE TO RECIPIENTS WITH COVER LETTERS INDICATING THE INTENDED PURPOSES. RECIPIENTS ARE ASKED TO PROVIDE FOLLOW-UPS ON THE USE OF THE FUNDS TO THE COMMITTEE WITHIN SIX MONTHS OF THE USE OF FUNDS. FORM 990, PART VI, LINE 6 - MEMBERS OF THE ORGANIZATION CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHSLI) IS A NEW YORK NOT-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS. CHSLI IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTRE. FORM 990, PART VI, LINE 7A - ELECTION OF THE GOVERNING BODY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTRE,AS THE SPONSOR OF CATHOLIC HEALTH SERVICES OF LONG ISLAND HAS THE ABILITY TO NOMINATE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, LINE 7B - DECISIONS OF THE GOVERNING BODY AS OUTLINED IN THE BY-LAWS OF CATHOLIC HEALTH SERVICES OF LONG ISLAND, CERTAIN BOARD DECISIONS ALSO REQUIRE THE APPROVAL OF THE ORGANIZATION'S MEMBERS. FORM 990, PART VI, LINE 11B - REVIEW PROCESS OF FORM 990 THE FORM 990 AND RELATED SCHEDULES ARE COMPLETED BY OUTSIDE TAX ADVISORS AND REVIEWED INTERNALLY BY MANAGEMENT. THE FINAL DRAFT OF THE FORM 990 IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD, AND PRESENTED TO THE COMPLIANCE AND AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF DIRECTORS OF CHS, WHICH HAS BEEN DELEGATED THE FORM 990 REVIEW FUNCTION BY THE BOARD. UPON REVIEW AND RECOMMENDATION OF THE COMMITTEE, THE FORM 990 IS THEN SENT TO THE BOARD FOR APPROVAL. UPON BOARD APPROVAL, THE FORM 990 IS SUBMITTED TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, LINE 12C - CONFLICT OF INTEREST POLICY DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY (THE POLICY) BY BOARD AND BOARD COMMITTEE MEMBERS, EMPLOYEES AND OTHERS THAT SATISFY THE CRITERIA TO BE CONSIDERED AN INTERESTED PERSON IS SUBMITTED UPON HIRE OR APPOINTMENT AND ANNUALLY THEREAFTER. SUCH INDIVIDUALS HAVE A CONTINUING OBLIGATION TO UPDATE THE INFORMATION PROVIDED DURING THE COURSE OF THE YEAR. A SUMMARY OF DISCLOSURES IS PROVIDED TO THE CHS COMPLIANCE AND AUDIT COMMITTEE BY CHS' COMPLIANCE OFFICER. ALL DISCLOSURES ARE INVESTIGATED AND INFORMATION RELATED TO THE DISCLOSURE IS GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE CHS COMPLIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE CHS BOARD OF DIRECTORS. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. IF A CONFLICT OF INTEREST IS IDENTIFIED AND A MAJORITY OF THE BOARD OR BOARD COMMITTEE AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS AND WISHES TO GO FORWARD WITH IT, THE CHAIR OF THE BOARD OF DIRECTORS SHALL PROVIDE A WRITTEN REQUEST TO THE CHAIR OF THE CHS COMPLIANCE AND AUDIT COMMITTEE, DELINEATING THE TRANSACTION AND CONFLICT AND PROVIDING REASONS WHY THE BOARD AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS, CERTIFIES THAT CHS CANNOT SECURE SIMILAR SERVICES FROM AN ORGANIZATION WITHOUT A CONFLICT, AND WISHES TO GO FORWARD WITH IT. THE PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST MUST RECUSE HIM/HERSELF FROM ANY DECISION MAKING OR VOTING ON THE INTEREST THAT GAVE RISE TO THE CONFLICT. FORM 990, PART VI, LINE 15 - COMPENSATION POLICY THE CHIEF EXECUTIVE OFFICER SUBMITS FOR APPROVAL TO THE SYSTEM CEO RECOMMENDATIONS FOR BASE SALARY ADJUSTMENTS AND INCENTIVE AWARDS FOR "DISQUALIFIED PERSONS" AS DEFINED IN THE CHS EXECUTIVE COMPENSATION POLICY (COMPENSATION POLICY). THE COMPENSATION POLICY DEFINES A "DISQUALIFIED PERSON" AS A PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF CHS OR AN OPERATING ENTITY, AND IS EITHER A) A VOTING MEMBER OF THE BOARD OF DIRECTORS OR BOARD OF TRUSTEES; B) THE ENTITY'S PRESIDENT, CHIEF EXECUTIVE OFFICER (CEO), AND CHIEF OPERATING OFFICERS (COO) OR PERSONS HOLDING EQUIVALENT POSITIONS; C) THE ENTITY'S TREASURERS AND CHIEF FINANCIAL OFFICERS (CFO); D) THE PERSON'S COMPENSATION IS PRIMARILY BASED ON REVENUES DERIVED FROM ACTIVITIES OF CHS OR AN OPERATING ENTITY, OR OF A PARTICULAR DEPARTMENT OR FUNCTION OF CHS OR AN OPERATING ENTITY, THAT THE PERSON CONTROLS; E) THE PERSON HAS OR SHARES AUTHORITY TO CONTROL OR DETERMINE A SUBSTANTIAL PORTION OF CHS OR AN OPERATING ENTITY'S CAPITAL EXPENDITURES, OPERATING BUDGET, OR COMPENSATION FOR OTHER EMPLOYEES; F) THE PERSON MANAGES A DEPARTMENT OR ACTIVITY OF CHS OR AN OPERATING ENTITY THAT REPRESENTS A SUBSTANTIAL PORTION OF THE ACTIVITIES, ASSETS, INCOME, OR EXPENSES OF CHS OR AN OPERATING ENTITY, COMPARED TO THE ORGANIZATION AS A WHOLE; OR G) FAMILY MEMBERS OF ANY OF THOSE DESCRIBED IN THE PRECEDING D, E, OR F. ONCE APPROVED BY THE CHS CEO, THESE RECOMMENDATIONS ARE SENT TO THE EXECUTIVE COMPENSATION COMMITTEE OF THE CHS BOARD OF DIRECTORS FOR REVIEW. THE EXECUTIVE COMPENSATION COMMITTEE, WITH AN INDEPENDENT COMPENSATION CONSULTANT ENGAGED BY THE BOARD, WILL REVIEW PROPOSED SALARY ADJUSTMENTS AND INCENTIVE AWARDS TO ENSURE REASONABLENESS BY REVIEWING COMPARABLE TOTAL COMPENSATION DATA (INCLUDING INCENTIVES) PAID TO SIMILARLY SITUATED EXECUTIVES AT THE MEDIAN OF THE DEFINED MARKETPLACE WITH POSSIBLE ADJUSTMENT MADE FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE AND PERFORMANCE, INCLUDING CONTRIBUTION TO THE SYSTEM AS A WHOLE. REVIEWS ARE PERFORMED ANNUALLY BY AN INDEPENDENT CONSULTANT. THE COMPENSATION COMMITTEE SETS STANDARDS TO ENSURE THAT THE CRITERIA USED TO DETERMINE INCENTIVE COMPENSATION ARE SPECIFIC, OBJECTIVE, MEASUREABLE AND RELATED TO INDICATORS OF PERFORMANCE. BASED ON THE INFORMATION PROVIDED, THE COMMITTEE WILL THEN MAKE ITS RECOMMENDATION TO THE CHS BOARD OF DIRECTORS. FORM 990, PART VI, LINE 16B - JOINT VENTURE POLICY CATHOLIC HEALTH SYSTEM OF LONG ISLAND HAS TAKEN STEPS TO SAFEGUARD THE ORGANIZATION'S EXEMPT STATUS. A POLICY WAS ADOPTED BY THE BOARD PRIOR TO THE END OF 2014 AND WILL BE FOLLOWED IN ALL NEW TRANSACTIONS. ALL JOINT VENTURES ENTERED INTO DURING 2014 WERE REVIEWED CONSISTENT WITH THE PROPOSED POLICY. FORM 990, PART VI, LINE 19 - DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION GOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE; CHS CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE AT DAC BOND. FORM 990, PART VII, SECTION A - LINE 1A HOURS FOR TRUSTEES ARE THE ESTIMATED WEEKLY HOURS (2.0) TRUSTEES CONTRIBUTE TO THIS AND ALL OTHER RELATED ORGANIZATIONS, NOT NECESSARILY EQUALLY BUT IN THE PROPORTION NECESSARY, FOR WHICH THEY RECEIVE NO COMPENSATION. COLLEEN BLYE, EXECUTIVE VICE PRESIDENT AND CHIEF FINANCIAL OFFICER - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766);RVC INSURANCE COMPANY, INC. (20-8067039) AND CATHOLIC HEALTH SYSTEMS OF LONG ISLAND (11-3403968). ALAN D. GUERCI, PRESIDENT & CEO - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766); RVC INSURANCE COMPANY, INC. (20-8067039); CATHOLIC HEALTH SYSTEMS OF LONG ISLAND (11-3403968); ST FRANCIS HOSPITAL (11-2050523); ST FRANCIS HOSPITAL RESEARCH & EDUCATION CORPORATION, INC. (11-3090867); ST FRANCIS HOSPITAL FOUNDATION (11-2916033); MERCY MEDICAL CENTER (11-1635088); WSNCHS NORTH, INC. (11-3438973); GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11-1888924); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); SIENA VILLAGE (06-1569129) AND ST. CHARLES HOSPITAL (11-1871039). CHS ACCOUNTABLE CARE ORGANIZATION LLC 992 N VILLAGE AVE ROCKVILLE CENTRE NY 11570 ACCNTBLE CARE NY 0 0 CHSLI CHS PHYSICIAN HOSPITAL ORGANIZATION LLC 992 N VILLAGE AVE ROCKVILLE CENTRE NY 11570 PHYSICIAN ORG NY 0 205562 CHSLI CHS SERVICES INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 113555766 SUPPORT ORG NY 501(C)(3) 11A- II CHSLI true CHS AMBULANCE SERVICES INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 141801961 DORMANT NY 501(C)(3) 3 CHSLI true GOOD SAMARITAN HOSPITAL MEDICAL CENTER 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 111888924 HOSPITAL NY 501(C)(3) 3 CHSLI true GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 112537396 SELF INSURANC NY 501(C)(3) 11A- I GOOD SAMARTN true MARYHAVEN TRANSPORTATION SERVICES 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113434776 TRANSPORTATIO NY 501(C)(3) 11A- I MARYHAVENCTR true MARYHAVEN CENTER OF HOPE 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 112861698 Prgm-disabled NY 501(C)(3) 9 CHSLI true MARYHAVEN SCHOOL CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 112861690 Schl-disabled NY 501(C)(3) 2 MARYHAVENCTR true THE CENTER OF HOPE FOUNDATION 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113638367 SUPPORT ORG NY 501(C)(3) 11A- I MARYHAVENCTR true MERCY MEDICAL CENTER 1000 NORTH VILLAGE AVENUE ROCKVILLE CTR NY 11570 111635088 HOSPITAL NY 501(C)(3) 3 CHSLI true CATHOLIC HOME CARE 110 BI-COUNTY BLVD SUITE 114 FARMINGDALE NY 11735 112126736 HOME CARE NY 501(C)(3) 9 CHSLI true OUR LADY OF CONSOLATION GERIATRIC CARE 111 BEACH DRIVE WEST ISLIP NY 11795 113284066 LT NURSE CARE NY 501(C)(3) 9 CHSLI true RIVERHEAD HOSTEL HOLDING CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 112499790 RENTING NY 501(C)(2) MARYHAVENCTR true SIENA VILLAGE INC 2000 BISHOPS ROAD SMITHTOWN NY 11787 061569129 SR HOUSING NY 501(C)(3) 9 STCATHERINE true ST CATHERINE OF SIENA MEDICAL CENTER 50 ROUTE 25A SMITHTOWN NY 11787 061562701 HOSPITAL NY 501(C)(3) 3 CHSLI true ST CHARLES HOSPITAL 200 BELLE TERRE ROAD PORT JEFFERSN ST NY 11777 111871039 HOSPITAL NY 501(C)(3) 3 CHSLI true CHS HOME SUPPORT SERVICES INC 15 POWER DRIVE HAUPPAUGE NY 11788 113594561 RESP THERAPY NY 501(C)(3) 9 CATHHOMECARE true ST FRANCIS HOSPITAL 100 PORT WASHINGTON BLVD ROSLYN NY 11576 112050523 HOSPITAL NY 501(C)(3) 3 CHSLI true ST FRANCIS HOSPITAL FOUNDATION 100 PORT WASHINGTON BLVD ROSLYN NY 11576 112916033 SUPPORT ORG NY 501(C)(3) 11A- I ST FRANCIS true ST FRANCIS HOSPITAL RESEARCH & EDUCATIO 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113090867 RESEARCH ORG NY 501(C)(3) 11A- I ST FRANCIS true WSNCHS NORTH INC 4295 HEMPSTEAD TURNPIKE BETHPAGE NY 11714 113438973 HOSPITAL NY 501(C)(3) 3 CHSLI true THE ST CHARLES CORPORATION 200 BELLE TERRE ROAD PORT JEFFERSN ST NY 11777 112983148 SUPPORT ORG NY 501(C)(3) 11A- I CHSLI true THE SAMARITAN CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 112716640 SUPPORT ORG NY 501(C)(3) 11A- I CHSLI true WISDOM GARDENS HOUSING DEVELOPMENT FUND 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113559713 SR HOUSING NY 501(C)(3) 9 MARYHAVENCTR true GOOD SHEPHERD HOSPICE 110 BI-COUNTY BLVD SUITE 114 FARMINGDALE NY 11735 112958438 HOSPICE SVC NY 501(C)(3) 9 CHSLI true ST CHARLES HOSPITAL FOUNDATION 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 412076312 SUPPORT ORG NY 501(C)(3) 11A- I ST CHARLES true GOOD SAMARITAN HOSPITAL FOUNDATION 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 770611240 SUPPORT ORG NY 501(C)(3) 11A- I GOOD SAMARTN true MERCY MEDICAL CENTER FOUNDATION 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 550813603 SUPPORT ORG NY 501(C)(3) 11A- I MERCY MEDCTR true ST CATHERINE OF SIENA MEDICAL CTR FDN 50 ROUTE 25A SMITHTOWN NY 11787 271459941 SUPPORT ORG NY 501(C)(3) 11A- I STCATHERINE true CHS HOME CARE AND HOSPICE FOUNDATION 110 BI-COUNTY BLVD SUITE 114 FARMINGDALE NY 11735 452907761 SUPPORT ORG NY 501(C)(3) 11A- I CATHHOMECARE true GOOD SHEPHERD HOSPICE FOUNDATION 110 BI-COUNTY BLVD SUITE 114 FARMINGDALE NY 11735 263169427 SUPPORT ORG NY 501(C)(3) 11A- I GOODSHEPHERD true OUR LADY OF CONSOLATION FOUNDATION 111 BEACH DRIVE WEST ISLIP NY 11795 450517566 SUPPORT ORG NY 501(C)(3) 11A- I OURLADYOFC true RVC SUPPORT 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 271531084 REAL ESTATE NY 501(C)(3) 11A- I CHSLI true ST FRANCIS CARDIOVASCULAR PHYSICIANS P 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113613997 HEALTHCARESVC NY 501(C)(3) 11A- I ST FRANCIS true RVC INSURANCE COMPANYINC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 208067039 CAPTIVE INS NY 501(C)(3) 11A- II CHSLI true SAMARITAN EMERGENCY MEDICAL SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208243412 HEALTHCARESVC NY 501(C)(4) GOOD SAMARTN true ST JOSEPH HOSPITAL FOUNDATION 992 N VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 472353387 SUPPORT ORG NY 501(C)(3) 11A- I WSNCHS NORTH true RADIOLOGY CONSULTING OF LONG ISLANDPLLC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 421646134 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SAMARITAN PEDIATRIC SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208180263 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SAMARITAN MEDICAL SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208088453 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SOUTHWEST SUFFOLK MEDICAL PC 580 UNION BOULEVARD WEST ISLIP NY 11795 061603195 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false CARDIAC EKG INTERPRETATION PC 992 N VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 112924518 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false LI REGIONAL ARTHRITIS & OSTEOPOROSIS CAR 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208964140 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SAMARITAN MANAGEMENT SERVICES 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 112838185 HEALTHCARE SVC NY CHSLI C-CORP false FAIRVIEW HILL MANAGEMENT CO INC 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 112798383 HOLDING CO NY CHSLI C-CORP false ADVANCED REHABILIATION MEDICINE PLLC 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 113640709 HEALTHCARE SVC NY STCHARLES HOSP C-CORP false ST FRANCIS CARDIAC PREVENTION SERVICES 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113224885 HEALTHCARE SVC NY STFRANCIS HOSP C-CORP false SOUTH SHORE PRACTICE MANAGEMENT 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 113307977 HEALTHCARE SVC NY SAMARITAN MGMT C-CORP false SAMARITAN HOME CARE AMERICA 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 113319259 HEALTHCARE SVC NY SAMARITAN MGMT C-CORP false HEALTH CARE TEMP SERVICES INC 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 112801136 EMPLOYMENT AGENCY NY FAIRVIEW HILL C-CORP false MERCY INTERNAL MEDICINE PC 992 N VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 510639649 HEALTHCARE SVC NY MERCY MED CTR C-CORP false LONG ISLAND EMERGENCY CARE PC 1000 N VILLAGE AVE ROCKVILLE CENTRE NY 115719024 113633515 PHYSICIAN SVC NY MERCY MED CTR S-CORP false true true true true true false false false true true true true true true true true true true true CHS SERVICES C 25233562 COST CHS SERVICES LMNOP 3834448 COST GOOD SAMARITAN HOSPITAL MEDICAL CENTER C 746687 COST GOOD SAMARITAN HOSPITAL MEDICAL CENTER LQS 157487 COST MERCY MEDICAL CENTER C 282013 COST MERCY MEDICAL CENTER LQS 58068 COST ST FRANCIS HOSPITAL C 708831 COST ST FRANCIS HOSPITAL LQS 132834 COST ST CHARLES HOSPITAL B 7554526 COST ST CHARLES HOSPITAL C 219640 COST ST CHARLES HOSPITAL LQS 72531 COST ST CATHERINE OF SIENA MEDICAL CENTER B 13400000 COST ST CATHERINE OF SIENA MEDICAL CENTER C 311197 COST ST CATHERINE OF SIENA MEDICAL CENTER DLQS 2002963 COST WSNCHS NORTH INC (ST JOSEPH HOSPITAL) B 13680000 COST WSNCHS NORTH INC (ST JOSEPH HOSPITAL) CLQS 210572 COST OUR LADY OF CONSOLATION GERIATRIC CARE CENTER CLQS 516613 COST MARYHAVEN CENTER OF HOPE CDLQS 1219754 COST SIENA VILLAGE LQS 91503 COST ST CATHERINE OF SIENA MEDICAL CENTER A 567979 COST MARYHAVEN CENTER OF HOPE A 132927 COST SCHEDULE R, PART IV FOR ALL PROFESSIONAL CORPORATIONS REPORTED ON SCHEDULE R, PART IV, THE PHYSICIAN IS THE SOLE SHAREHOLDER OF THE ENTITY AND THE DIRECT CONTROLLING ENTITY REPORTED IN COLUMN (D) IS THE BENEFICIAL OWNER. THIS STRUCTURE IS CONSISTENT WITH THE NEW YORK CORPORATE PRACTICE OF MEDICINE.